Throat - H + N cancer Flashcards
What type of cancer are the majority of H+N cancers
SCC
Presentation H+N cancers (7)
Dysphagia/Odynophagia Painful throat Progressive/constant hoarse voice Neck lump Rx otalgia Bleeding in mouth/throat Persistent ulceration
RF H+N cancer (4)
Smoking
Alcohol
EBV
HPV
Pathology to be considered: Neck Level I
Submandibular gland
Tooth abscess
Pathology to be considered: Neck Level II
Parotid
Branchial cyst
Lymphadenopathy (benign/malignant)
Pathology to be considered: Neck Level III
Branchial cyst
Paragangliomas
Lymphadenopathy
Pathology to be considered: Neck Level IV
Lymphadenopathy
Pathology to be considered: Neck Level V
Cystic hygroma
Lymphadenopathy
Pathology to be considered: Neck Level VI
Thyroid goitre/nodule
Thyroglossal duct cust - MIDLINE
Dermoid cyst - MIDLINE
+ epidermoid cyst
Causes of vocal cord motion impairment (7)
URTI Strong odor/fumes Tobacco smoke Post-nasal drip Acid reflux Strong emotions/stress
Leukoplakia
White patches on oral mucosa
What does leukoplakia usually represent?
Hyperkeratinosis
Triggers of leukoplakia (3)
Smoking
Dentures
Spice
What % of leukoplakia will undergo malignant changes?
3%
What is the sign of a malignant change in leukoplakia?
Erosion/ulceration
Mx Leukoplakia (3)
Remove irritant
Retinoids
Surgical excision
Erythroplakia
Macular well defined red patches in mouth
What is erythroplakia associated with
Dysplasia –> pre-cancerous
Red flag Sx H+N (8)
Unexplained neck lump thats changed over 3-6w
Hoarse voice >3w
New onset dysphagia
Unexplained persistent swelling in salivary glands
Otalgia >4 w + norm otoscopy
Unexplained persistent sore/painful throat
Non healing ulcers
White/red lesion in mouth/oropharynx
Non-healing ulcers
White/red lesion in mouth/oropharynx
Diagnostic methods H+N malignancy (6)
Hx FNAC CT/MRI CXR Bloods Biopsy if possible
RF Oropharnygeal cancer (4)
Smoking abuse
Alcohol abuse
HPV
IDA
Sx oropharyngeal cancer (7)
Sore throat Odynophagia Dysphagia Otalgia Bleeding Trismus Hoarseness
Sx Hypopharyngeal cancer (8)
Sore throat Odynophagia Dysphagia Otalgia Haemoptysis Hoarseness Stridor Neck mass
Where are hypophyarnygeal cancers mainly located (2)
Piriform sinuses
Posterior pharyngeal wall
RF Laryngeal cancer (3)
Smoking
Alcohol abuse
Previous neck radiation
% of laryngeal cancers; glottis, supraglottis + subglottis
Supraglottis - 45%
Glottis - 50%
Subglottis - 5%
Tx of oral Ca
Surgery + radiotherapy
